Retrograde ureteroscopic endopyelotomy provides a safe and adequate first line of treatment for patients suffering from UPJO, but patients with crossing vessels, patulous redundant renal pelvis, and borderline salvageable renal function should undergo alternative treatment modalities, such as open or laparoscopic pyeloplasty or nephrectomy, rather than be subjected to endopyelotomy.

A thorough head and neck evaluation is important to rule out other sources of aural fullness, such as temporomandibular dysfunction, superior canal dehiscence, barotrauma, and patulous eustachian tube.

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